Monoclonal antibody and antigens for diagnosing and treating lung disease and injury

ABSTRACT

The present invention provides methods for diagnosing a patient with emphysema, COPD of lung injury caused by tobacco use by detecting the levels of EMAP II in a sample. Disclosed herein are the hypervariable regions for a rat monoclonal antibody that binds to a form of EMAP II. This disclosure also includes a polypeptide sequence included in EMAP II that is the target for the binding of the antibody to its target protein. This epitope serves as the basis for a humanized antibody that can be used to treat patients that suffer from pathologies that exhibit elevated levels of EMAP II expression.

PRIORITY CLAIM

This application claims the benefit of U.S. Provisional PatentApplication No. 61/494,720, filed on Jun. 8, 2011 and incorporatedherein by reference in its entirety.

STATEMENT OF GOVERNMENT RIGHTS

This invention was made with government support under HL090950 awardedby the National Institutes of Health. The U.S. Government has certainrights in the invention.

FIELD

The present invention is directed generally to method for diagnosing andtreating a patient with emphysema or chronic obstructive pulmonarydisease (COPD), and more particularly to methods for diagnosing andtreating a patient with emphysema or COPD by detecting the presence ofendothelial monocyte activating protein II (EMAP II) and neutralizingEMAP II action.

BACKGROUND

Over 3.1 million Americans have been diagnosed with emphysema. Emphysemaand chronic bronchitis are the two components of the syndrome of COPD.COPD is the fourth leading cause of death in America (Seewww.nhlbi.nih.gov/health/public/lung/other/copd_fact.htm#toc). Thisdisease has no effective treatment that reverses its course or halts itsprogression.

Pulmonary emphysema is a prevalent fatal disease, characterized by lossof both matrix and cellular elements of the lung, thus impairing gasexchange between the alveolar space and the capillary blood. Emphysemais defined as “a condition of the lung characterized by abnormal,permanent enlargement of airspaces distal to the terminal bronchiole,accompanied by destruction of their walls, with or without obviousfibrosis”. Report of a National Heart, Lung, and Blood Institute,Division of Lung Diseases workshop, Am Rev Respir Dis 132, 182-185.(1985). The concepts of permanent and destruction are critical in thisdefinition as they convey the unique and characteristic distinguishingfeatures of a disease process ultimately leading to the disappearance oflung tissue.

Although the environmental inducers in susceptible individuals have beenidentified, the mechanisms by which these initiate a loss of alveolileading to emphysema are poorly understood. Over the past decades,inflammation and a protease/antiprotease imbalance have been proposed toact as downstream effectors of the lung destruction following chroniccigarette smoking, which accounts for most cases of emphysema.Pro-inflammatory stimuli are postulated to recruit and activate lunginflammatory cells, triggering matrix protease release and lungremodeling. Shapiro, S. D., J Clin Invest 106, 1309-1310 (2000).However, these models fail to fully account for the mechanisms behindthe eradication of septal structures and the unique nature of lungdestruction as compared to alterations seen in other inflammatory lungdiseases. To account for the permanent destruction seen in emphysema,excessive apoptosis of structural alveolar cells have emerged as asecond major mechanism of emphysema. Excessive alveolar endothelialapoptosis is thought to cause capillary regression, with subsequent lossof alveolar wall. Tuder, R. M. et al., Am J Respir Cell Mol Biol 28,551-554 (2003). However, the coexistence of an excessive lung structuralcell apoptosis with that of an activated inflammatory state in emphysemaand the hierarchy of these two mechanisms have not yet been explained.

As can be seen, there is a need for a method for treating pulmonaryemphysema. There is also a need for a method for diagnosing pulmonaryemphysema in the early stages. Early diagnosis and subsequent treatmentmay result in more effective treatment of the disease and a betterprognosis for the patient.

SUMMARY

In one aspect of the present invention there is provided a method ofdiagnosing a patient for emphysema or COPD comprising detecting theoverexpression of EMAP II in a patient's biological sample where thesample may be serum, plasma, lung lavage or lung biopsy. The EMAP II maybe detected by immunological methods such as enzyme-linked immunosorbentassay (ELISA), sandwich ELISA, Western blot, or mass spectrometry, forexample. The overexpression of EMAP II may be determined by comparing toa control sample.

In another aspect of the present invention there is provided a method ofpredicting a patient's susceptibility of developing emphysema or COPD bydetecting the presence of EMAP II in a patient's sample.

In a further aspect of the present invention there is provided a methodfor treating a patient having emphysema or COPD comprising administeringa therapeutically effective amount of an EMAP II neutralizing compound.The EMAP II neutralizing compound may be an antibody, an agonist of theCXCR3 receptor, an siRNA or antisense RNA. The EMAP II neutralizingcompound may be administered systemically or by inhalation.

Aspects of the invention include antibodies, either humanized ornot-humanized, comprising: a heavy chain variable region, wherein saidheavy chain variable region includes at least a portion of a firstpolypeptide according to SEQ. ID. NO. 2; and a light chain variableregion, wherein said light chain variable region includes at least aportion of a second polypeptide according to SEQ. ID. NO. 3, wherein theantibodies bind to at least one form of EMAPII. In some embodiments thefirst polypeptide has at least 99 percent homology to SEQ. ID. NO. 2,and said second polypeptide has at least 99 percent homology to SEQ. ID.NO. 3. In other embodiments, the first polypeptide has at least 95percent identity to SEQ. ID. NO. 2, and said second polypeptide has atleast 95 percent identity to SEQ. ID. NO. 3. In other embodiments thefirst polypeptide has at least 99 percent identity to SEQ. ID. NO. 2,and said second polypeptide has at least 99 percent identity to SEQ. ID.NO. 3. And in still other embodiments, the first polypeptide is SEQ. ID.NO. 2, and said second polypeptide is SEQ. ID. NO. 3. In someembodiments the antibodies bind to at least the pro form of EMAPII(pro-EMAPII), and in some embodiments the antibodies bind to EMAPIIfound in humans and/or in mice and/or in other mammals.

Some aspects of the invention include antibodies, comprising: a heavychain, wherein said heavy chain includes the heavy chain hypervariableregions CDR1, CDR2 and CDR3, wherein CDR1 includes at least a portion ofthe polypeptide according to SEQ. ID. NO. 5, CDR2 includes at least aportion of the polypeptide according to SEQ. ID. NO. 6, and CDR3includes at least a portion of the polypeptide according to SEQ. ID. NO.7; and a light chain, wherein said light chain includes the light chainhypervariable regions CDR1_(L), CDR2_(L), and CDR3_(L), wherein CDR1_(L)includes at least a portion of the polypeptide according to SEQ. ID. NO.8, CDR2_(L) includes at least a portion of the polypeptide according toSEQ. ID. NO. 9 and CDR3 L includes at least a portion of the polypeptideaccording to SEQ. ID. NO. 10, wherein the heavy chain and the lightchain form a portion of a humanized antibody, that binds to humanEMAPII. In some embodiments, CDR1 is SEQ. ID. NO. 5, CDR2 is SEQ. ID.NO. 6, and CDR3 is SEQ. ID. NO. 7; and CDR1_(L) is SEQ. ID. NO. 8,CDR2_(L) is SEQ. ID. NO. 9, and CDR3_(L) is SEQ. ID. NO. 10. In someembodiments the antibodies bind to at least the pro form of EMAPII(pro-EMAPII), and in some embodiments the antibodies bind to EMAPIIfound in humans and/or in mice and/or in other mammals. In someembodiments the antibodies are humanized.

Some aspects of the invention include epitopes, or other antigenicportions of EMAPII, that give rise to antibodies that bind to at leastone form of mammalian EMAPII, comprising: an epitope of human EMAP II,wherein the epitope includes at least a portion of an isolatedpolypeptide according to SEQ. ID. NO. 12. In some embodiments, theisolated polypeptide has at least 95 percent homology to SEQ. ID. NO.12. In still other embodiments, the isolated polypeptide has at least 99percent homology to SEQ. ID. NO. 12. In yet other embodiments, theisolated polypeptide has at least 95 percent identity to SEQ. ID. NO.12, while in some embodiments, the isolated polypeptide has at least 99percent identity to SEQ. ID. NO. 12. In some embodiments, the isolatedpolypeptide is SEQ. ID. NO. 12. In some embodiments, the isolatedpolypeptide has at least 95 percent identity to SEQ. ID. NO. 11. Instill other embodiments, the isolated polypeptide has at least 99percent identity to SEQ. ID. NO. 11. In some embodiments, the isolatedpolypeptide is SEQ. ID. NO. 11. Some embodiments include these epitopes,or portions thereof, attached to at least one other polypeptide. Suchco-joined polypeptides may not be naturally occurring, at least not inthe organism that is expressing the polypeptide.

Some aspects of the invention include methods for making antibodies thatbind to at least one form EMAPII found in either humans or in othermammals, these methods may comprise the steps of: producing a syntheticpolypeptide wherein at least one portion of the synthetic polypeptideincludes at least a portion of the polypeptide according to SEQ. ID. NO.12. In some embodiments, the at least one portion of the syntheticpolypeptide has at least 95 percent homology to SEQ. ID. NO. 12. Instill other embodiments, that at least one portion of the syntheticpolypeptide has at least 99 percent homology to SEQ. ID. NO. 12. In yetother embodiments, that at least one portion of the syntheticpolypeptide has at least 95 percent identity to SEQ. ID. NO. 12. In someembodiments, the at least one portion of the synthetic polypeptide hasat least 99 percent identity to SEQ. ID. NO. 12. In still otherembodiments, the at least one portion of the synthetic polypeptide isSEQ. ID. NO. 12. In some embodiments, the at least one portion of thesynthetic polypeptide has at least 95 percent homology to SEQ. ID. NO.11. In other embodiments, the at least one portion of the syntheticpolypeptide has at least 99 percent homology to SEQ. ID. NO. 11. Instill other embodiments, the at least one portion of the syntheticpolypeptide has at least 95 percent identity to SEQ. ID. NO. 11. In yetother embodiments, the at least one portion of the synthetic polypeptidehas at least 99 percent identity to SEQ. ID. NO. 11. In someembodiments, at least one portion of the synthetic polypeptide is SEQ.ID. NO. 11. The inventive methods may include the step of contacting asynthetic polypeptide that includes at least one portion of at least oneepitope of EMAPII disclosed herein with the immune system of a mammal.Some methods may include the further step of selecting a B-cell fromsaid mammal contacted with said synthetic polypeptide, wherein saidB-cell produces antibody that binds with high affinity to EMAPII. And insome embodiments, the antibodies raised to the epitopes disclose hereinare humanized. In some embodiments, the humanized antibodies are used totreat a lung related disease or injury in humans and/or other mammals,or to diagnose such conditions in humans and/or other animals.

These and other features, aspects and advantages of the presentinvention will become better understood with reference to the followingdrawings, description and claims.

SEQUENCE LISTING SEQ. ID. NO. 1 GCGGTGCACCTTGTTGAGTCTGGTGGAGGATTTGTNucleotide sequence GCAGCCTACGGAGTCATTGAAAATCTCATGTGCA of the IgG heavyGCCTCTGGATTCACCTTCAGTGATGCTGCCATGTA chain from ratCTGGGTCCGCCAGGCTCCAGGAAAGGGTCTGGAA antibody hybridomaTGGGTTGCTCGCATAAGAACTAAACCTAATAATT clone M7/1.ATGCAACATATTATGCTGATTCAGTGAAAGGCAG ATTCACCATCTCCCGAGATGATTCAAAAAGCATGGTCTACCTACAAATGGATAACTTGAAAACTGAGG ACACAGCCATGTATTACTGTACATCATGGAGCTACGACTTTGATTACTGGGGCCAAGGAGTCATGGTC ACAGTCTCCTCA SEQ. ID. NO. 2AVHLVESGGGFVQPTESLKISCAASGFTFSDAAMY Polypeptide sequenceWVRQAPGKGLEWVARIRTKPNNYATYYADSVKGR of the IgG heavyFTISRDDSKSMVYLQMDNLKTEDTAMYYCTSWSY chain from rat DFDYWGQGVMVTVSSantibody hybridoma clone M7/1. SEQ. ID. NO. 3DIVMTQGALPNPVPSGESASITCQSSKSLLHSSGKTY Polypeptide sequenceLNWYLQRPGQSPHLLIYWMSTRASGVSDRLSGSGS of the IgG light chainGTDFTLKISSVEAEDVGVYYCQQFLEYPLTFGSGTK from rat antibody LEIKhybridoma clone M7/1. SEQ. ID. NO. 4 GATATTGTGATGACCCAGGGTGCACTCCCCAACCNucleotide sequence CTGTCCCCTCTGGAGAGTCAGCTTCCATCACCTGCof the IgG light chain CAGTCTAGTAAGAGTCTGCTGCACAGCAGTGGCAfrom rat antibody AGACATACTTGAATTGGTATCTGCAGAGGCCAGG hybridoma cloneACAGTCTCCTCATCTCCTGATCTATTGGATGTCCA M7/1.CCCGTGCATCAGGAGTCTCAGACAGGCTCAGTGG CAGTGGGTCAGGAACAGATTTCACACTGAAAATCAGCAGCGTGGAGGCTGAGGATGTGGGTGTGTATT ACTGTCAGCAATTTCTAGAGTATCCTCTCACGTTCGGTTCTGGGACCAAGCTGGAGATCAAAC SEQ. ID. NO. 5 GFTFSDAA Polypeptide CDR1from IgG heavy chain of rat antibody hybridoma clone M7/1.SEQ. ID. NO. 6 IRTKPNNYAT Polypeptide CDR2 from IgG heavy chainof rat antibody hybridoma clone M7/1. SEQ. ID. NO. 7 TSWSYDFDYPolypeptide CDR3 from IgG heavy chain of rat antibody hybridoma cloneM7/1. SEQ. ID. NO. 8 KSLLHSSGKTY Polypeptide CDR1 from IgG light chainof rat antibody hybridoma clone M7/1. SEQ. ID. NO. 9 WMSPolypeptide CDR2 from IgG light chain of rat antibody hybridoma cloneM7/1. SEQ. ID. NO. 10 QQFLEYPLT Polypeptide CDR3 from IgG light chainof rat antibody hybridoma clone M7/1. SEQ. ID. NO. 11QQSIAGSADSKPIDVSRLDLRIGCIITARKHPDADSLY Polypeptide sequenceVEEVDVGEIAPRTVVSGLVNHVPLEQMQNRM identified in human EMAPII as theportion of the protein that is protected from trypsin digestion bythe binding of rat antibody hybridoma clone M7/1. SEQ. ID. NO. 12QQSIAGSADSKPIDVSR Polypeptide sequence from human EMAPIIthat interacts with rat antibody hybridoma clone M7/1. SEQ. ID. NO. 13KHPDADSLYVEEVDVGE Polypeptide sequence from human EMAPIIthat does not appear to interact strongly with rat antibodyhybridoma clone M7/1. SEQ. ID. NO. 14 VLKRLEQKGAEADQIIERandom, synthetic polypeptide sequence that does not interactwith rat antibody hybridoma clone M7/1. SEQ. ID. NO. 15MLPAVAVSEPVVLRFMIFCRLLAKMANNDAVLKRL Polypeptide sequenceEQKGAEADQIIEYLKQQVSLLKEKAILQATLREEKK of human EMAPII.LRVENAKLKKEIEELKQELIQAEIQNGVKQIPFPSGTPLHANSMVSENVIQSTAVTTVSSGTKEQIKGGTGDEKKAKEKIEKKGEKKEKKQQSIAGSADSKPIDVSRLDLRIGCIITARKHPDADSLYVEEVDVGEIAPRTVVSGL VNHVPLEQMQNRMVILLCNLKPAKMRGVLSQAMVMCASSPEKIEILAPPNGSVPGDRITFDAFPGEPDKELNPKKKIWEQIQPDLHTNDECVATYKGVPFEVKGKGV CRAQTMSNSGIK

BRIEF DESCRIPTION OF THE DRAWINGS

FIG. 1. A bar graph illustrating an increase in secreted EMAP IIexpression in humans in the broncho-alveolar lavage (BAL) of smokerscompared to non-smokers.

FIG. 2A. A bar graph showing the effect of cigarette smoke (CS) exposureon the activity levels of caspase-3 in mouse lungs.

FIG. 2B. A bar graph showing the effect of cigarette smoke on the levelsof pro-apoptotic ceramide levels in mouse lungs.

FIG. 2C. A bar graph of the alveolar size in mice exposed to cigarettesmoke for 6 months.

FIG. 3A. A bar graph that illustrates the effect of cigarette smokeexposure on the levels of EMAP II expression.

FIG. 3B. A Western blot showing the kinetics of EMAP II secretion in BALfrom mice exposed to cigarette smoke (CS) or air (AC).

FIG. 3C. A Western blot showing VEGF receptor inhibition with SU5416.

FIG. 4A. A bar graph and Western blot that illustrates the effect ofcigarette smoke exposure on EMAP II levels in lung lysates.

FIG. 4B. Photomicrographs that show the effect of cigarette smokeexposure on the amount of inflammatory cells in lung tissue.

FIG. 5A. A Western blot showing the induction of EMAP II in mice after24 hours of tetracycline treatment.

FIG. 5B. Photomicrographs of a lung section showing the alveolar aftertetracycline treatment for 3 months.

FIG. 5C. A bar graph showing the mean linear intercept of lung tissue ofmice treated with tetracycline for 3 months and controls.

FIG. 5D. Photomicrographs of a lung section showing the alveolar aftertetracycline treatment for 6 months.

FIG. 5E. A bar graph showing the volume weighted mean volume of lungtissue of mice treated with tetracycline for 6 months and controls.

FIG. 6A. A graph showing the caspase-3 activity in lung lysates ofsingle or EMAP II double transgenic mice after 3 months.

FIG. 6B. A graph showing caspase-3 activity in lung lysates from singleor EMAP II double transgenic mice after 6 months.

FIG. 6C. A graph showing caspase-3 activity in lungs of single or EMAPII double transgenic mice treated with nonspecific control IgG andneutralizing EMAP II antibody.

FIG. 7A. A bar graph showing the number of cells in the lungs of miceoverexpressing EMAP II compared to a control.

FIG. 7B. A bar graph showing the quantification MMP-9- and TNFα-positivecells.

FIG. 8A. A bar graph showing the effect of EMAP II overexpression oncaspase-3 activity.

FIG. 8B. A graph showing the effect of treatment of lung microvascularendothelial cells with recombinant proteins comprising the pro- andmature isoforms of EMAP II on apoptosis.

FIG. 8C. A bar graph showing the expression levels of CXCR3 in cellscultured with low serum.

FIG. 8D. A bar graph showing the expression levels of CXCR3 in cellstreated with acellular BAL from mice exposed to cigarette smoke (CS) orair (AC).

FIG. 8E. A bar graph showing the effect of anti-CXCR3 antibody oncaspase-3 activity.

FIG. 9. A bar graph showing the effect of CXCR3-targeting siRNA on CXCR3expression.

FIG. 10A. An immunoblot showing the effect of cigarette smoke exposureon EMAP II expression in the mouse lung.

FIG. 10B. A bar graph showing EMAP II expression in the lung parenchymaof DBA2 mice exposed to cigarette smoke for 4 weeks.

FIG. 10C. An immunoblot showing lung EMAP II expression in a mouse modelof apoptosis-dependent emphysema.

FIG. 10D. A bar graph showing lung macrophage accumulation in pulmonaryparenchyma in response to cigarette smoke exposure.

FIG. 10E. A bar graph showing lung apoptosis as measured by caspase-3activity assay in lung lysates following cigarette smoke exposure.

FIG. 11A. Fluorescent microscope images showing inhibition of EMAPII-induced apoptosis in endothelial cells with neutralizing antibody M7/1 compared to control rat IgG.

FIG. 11B. A bar graph showing the ratio of apoptotic cells to totalcells for pro-EMAPII with neutralizing antibody M 7/1 compared tocontrol rat IgG.

FIG. 11C. A bar graph showing the ratio of apoptotic cells to totalcells for mature EMAPII with neutralizing antibody M 7/1 compared tocontrol rat IgG.

FIG. 12A. Graph of EMAPII (pro and mature forms) in lung lysates frommice exposed to Cigarette Smoke (CS) for 4 weeks compared with EMAPIIlevels in the lungs of mice that were not exposed to CS (ambient aircontrol group, AC); EMAPII levels were assessed by Western blots (meandensitometry units [DUs] normalized to vinculin±SEM; *P<0.05 versuscontrol; n=5/group).

FIG. 12B. Photomicrographs of mouse lung tissue stained for EMAPII;tissue from mice exposed to CS and from exposed to ambient air (AC).

FIG. 12C. Schematic representation of treatment protocol.

FIG. 12D. Graph showing apoptosis detected by caspase-3 activitymeasured in lung lysates (caspase unites normalized by protein;mean±SEM; *P<0.05, ANOVA).

FIG. 12E. Graph showing the number of cells in BALF.

FIG. 12F. Graph showing lung static compliance (mean±SEM; *P<0.01,ANOVA).

FIG. 12G. Representative H&E-stained lung sections (scale bar: 100 μm)showing simplification of lung alveolar structures in response to CS butperseved alveolar architecture when treated with neutralizing EMAPII,

FIG. 12H. Morphometric measurement of MLI (mean±SEM: *P<0.05, ANOVA:n=5-12.

FIG. 13. Agarose gel showing PCR amplification products.

FIG. 14. Summary of results from sequences of rat antibody.

FIG. 15. Sequence data for the variable regions of the rat antibody.

FIG. 16. Scheme of EMAP II protein sequence. A range, which is protectedfrom proteolytic degradation by binding to M7/1 antibody is highlighted.

FIG. 17. Binding competition of one peptide out of the protected areawhich is capable of competing with M7/1 antibody. Recombinant pro-EMAPII was submitted to Western blotting using control IgG and EMAP IIneutralizing M7/1 antibody in the presence/absence of a 300 fold molarexcess of peptide hexadecamers. Only Peptide 2 (QQSIAGSADSKPIDVSR) butnot Peptide 1 (KHPDADSLYVEEVDVGE) or Peptide 3 (as a control) was ableto compete with M7/1. Arrows indicate the position of molecular weightstandards (in rel kDa).

DESCRIPTION

The following detailed description is of the best currently contemplatedmodes of carrying out the invention. The description is not to be takenin a limiting sense, but is made merely for the purpose of illustratingthe general principles of the invention, since the scope of theinvention is best defined by the appended claims. As used herein, unlessexplicitly stated otherwise or clearly implied otherwise, the term‘about’ refers to a range of values plus or minus 10 percent, e.g. about1.0 encompasses values from 0.9 to 1.1.

As used herein, unless explicitly stated otherwise or clearly impliedotherwise, the terms ‘therapeutically effective dose,’ ‘therapeuticallyeffective amounts,’ and the like, refer to a portion of a compound thathas a net positive effect on the health and well being of a human orother animal. Therapeutic effects may include an improvement inlongevity, quality of life and the like, and may also include a reducedsusceptibility to developing disease or deteriorating health or wellbeing. The effects may be immediate realized after a single dose and/ortreatment or they may be cumulative and realized after a series of dosesand/or treatments.

As used herein, unless explicitly stated otherwise or clearly impliedotherwise, the term ‘homology’ as applied to polynucleotides refers to 3nucleic acid long Condons that, while not identical to one another,encode the same information when transcribed into proteins. For afurther discussion of this term as it is used in regards topolynucleotides, please see, Elliot and Elliot, Biochemistry andMolecular Biology, pages 293-295, published in 1997 by Oxford UniversityPress, New York, N.Y., this portion of which is hereby incorporatedherein by reference in its entirety.

As used herein, unless explicitly stated otherwise or clearly impliedotherwise, the term ‘homology’ as applied to polypeptides refers toamino acids commonly found in living organisms that are considered to besimilar to one another in size, structure, and chemical reactivity. Fora further discussion of this term as it is used in regards topolypeptides, please see, Stryer, L., Biochemistry, 2^(nd) edition,pages 13-17, copyright 1981, published by W. H. Freeman and Company, SanFrancisco, Calif., this portion of which is hereby incorporated hereinby reference in its entirety.

Broadly, the present invention provides methods for diagnosing ortreating a patient with emphysema or COPD comprising detecting thepresence of EMAP II in a biological sample from a patient or treatingwith a therapeutically effective amount of an EMAP II neutralizingcompound. The same method may also be used to determine if a patient issusceptible to developing emphysema or COPD. EMAP II is a cytokineinduced by conditions present in emphysematous lungs includingoxidative, apoptotic, and hypoxic cellular stresses. EMAP II is releasedfrom cells as either a 43 kD pro-form or a 23 kDa “mature” protein uponproteolytic cleavage by proteases including caspases and matrixmetalloproteinases (MMPs), which are known to participate in COPD. Giventhe potent pro-apoptotic effect of EMAP II on lung endothelial cells,coupled with its ability to recruit pro-inflammatory monocytes,excessive EMAP II release in response to cigarette smoking may engageboth lung endothelial cell apoptosis and accumulation of lungmacrophages, and therefore may be a key molecular mediator of pulmonaryemphysema. It has now been discovered by the inventors thatsmoke-induced emphysema is preceded by robust EMAP II production andapoptosis in mice and that lung-specific increases in EMAP II aresufficient to cause lung apoptosis and emphysema. Moreover, increasedlevels of EMAP II have now been measured in the lungs of emphysemapatients and EMAP II has been found to be robustly upregulated in theBAL of smokers (FIG. 1). Therefore, EMAP II may be a biomarker foremphysema and COPD, allowing for earlier detection and treatment ofthese conditions.

In one embodiment a method is provided for diagnosing whether or not apatient has emphysema or COPD where the method may comprise the step ofdetecting EMAP II in a biological sample from a patient. It has beenfound that expression of EMAP II is significantly elevated by at least2-fold in samples from patients who have emphysema or COPD. The methodmay further comprise comparing the EMAP II detected in the patient'ssample with a control and diagnosing the patient as either havingemphysema or COPD. The control may be a sample from a patient who doesnot have emphysema or COPD and, more specifically, from a patient whodoes not smoke. Control levels of EMAP II may be defined by a number ofsamples from control patients wherein the expression levels of EMAP II.It will be appreciated that the more control samples available, thebetter the comparison. The comparison may be a visual comparisonobserving elevated EMAP II levels or the amount of EMAP II in the sampleand/or control may be quantified and then compared.

In one embodiment, the biological sample may be serum, plasma, BAL, orlung biopsy. Obtaining such samples is routine in the art. Theoverexpression of EMAP II in a biological sample may be assessed at theprotein or nucleic acid level. In an illustrative embodiment,immunocytochemistry techniques are provided that utilize antibodies todetect the overexpression EMAP II in biological samples. In this aspectof the invention, at least one antibody directed to EMAP II may be used.Overexpression of EMAP II may also be detected by nucleic acid-basedtechniques, including, for example, hybridization and RT-PCR. Kitscomprising reagents for practicing the methods of the invention arefurther provided.

Methods for detecting EMAP II may comprise any methods that determinethe quantity or the presence of EMAP II either at the nucleic acid orprotein level. Such methods are well known in the art and include butare not limited to Western blots, northern blots, southern blots, ELISA,immunoprecipitation, immunofluorescence, flow cytometry,immunocytochemistry, nucleic acid hybridization techniques, nucleic acidreverse transcription methods, and nucleic acid amplification methods.In illustrative embodiments, overexpression of EMAP II may be detectedon a protein level using, for example, antibodies that are directedagainst specific biomarker proteins. The antibodies may be, but are notlimited to, polyclonal and monoclonal antibodies. Examples of monoclonalantibodies are provided herein as well as in U.S. Pat. No. 5,641,867,which is incorporated by reference herein. These antibodies can be usedin various methods such as Western blot, ELISA, immunoprecipitation, orimmunocytochemistry techniques.

In one embodiment, EMAP II overexpression may be determined on theprotein level. Antibodies specific for EMAP II may be utilized to detectthe overexpression of a biomarker protein in a body sample. The methodcomprises obtaining a body sample from a patient, contacting the bodysample with at least one antibody directed to EMAP II, and detectingantibody binding to determine if EMAP II is overexpressed in the patientsample. Overexpression of EMAP II may be determined by comparing theresults to a control sample.

In an alternate embodiment, EMAP II overexpression may be detected atthe nucleic acid level. Nucleic acid-based techniques for assessingexpression are well known in the art and include, for example,determining the level of biomarker mRNA in a body sample. Manyexpression detection methods use isolated RNA. Any RNA isolationtechnique that does not select against the isolation of mRNA can beutilized for the purification of RNA from cervical cells (see, e.g.,Ausubel et al., ed., Current Protocols in Molecular Biology, John Wiley& Sons, New York, 1987-1999). Additionally, large numbers of tissuesamples can readily be processed using techniques well known to those ofskill in the art, such as, for example, the single-step RNA isolationprocess of U.S. Pat. No. 4,843,155, which is incorporated by referenceherein.

Isolated mRNA may be used in hybridization or amplification assays thatinclude, but are not limited to, Southern or Northern analyses,polymerase chain reaction analyses and probe arrays. One method for thedetection of mRNA levels involves contacting the isolated mRNA with anucleic acid molecule (probe) that can hybridize to the mRNA encoded bythe gene being detected. The nucleic acid probe may be, for example, afull-length cDNA, or a portion thereof, such as an oligonucleotide of atleast 7, 15, 30, 50, 100, 250 or 500 nucleotides in length andsufficient to specifically hybridize under stringent conditions to anmRNA or genomic DNA encoding a biomarker of the present invention. Thepolynucleotide sequence of EMAP II is known in the art (i.e., U.S. Pat.No. 6,013,483, which is incorporated by reference herein), and nucleicacid probes may be selected without undue experimentation. Hybridizationof an mRNA with the probe indicates that the biomarker in question isbeing expressed.

In another embodiment, methods are provided for determining a patient'ssusceptibility to developing emphysema or COPD. Although no symptoms maybe present, those who smoke or were habitual smokers in the past have asignificantly higher risk of developing emphysema than those who neversmoked. Therefore, it may be desirable to determine the susceptibilityof a patient who is a smoker to develop emphysema. Early detection maylead to a better treatment regime. The method may comprise the step ofdetecting EMAP II in a patient's sample as described above. The methodmay further comprise comparing the EMAP II in the patient's sample witha control as described above.

In yet another embodiment, kits for practicing the methods of thepresent invention are further provided. The kit may comprise at leastone reagent (e.g., an antibody, a nucleic acid probe, etc.) forspecifically detecting the expression of EMAP II. The kits may alsocomprise positive and/or negative controls to validate the activity andcorrect usage of reagents employed in accordance with the invention.Controls may include biological samples, such as lung tissue or lunglavage samples from control patients (negative control). EMAP II may beadded to the control samples to provide positive controls.

In a further embodiment, methods are provided for treating a patienthaving emphysema or COPD comprising the step of administering atherapeutically effective amount of at least one EMAP II neutralizingcompound. The neutralizing compound may be any compound or molecule thatdecreases or inhibits the activity or action of EMAP II in the patient.In one embodiment the neutralizing compound may be an anti-EMAP IIantibody where the antibody may be a polyclonal or monoclonal antibody,antibody fragments, humanized or chimeric antibodies that retain thecombining region that specifically binds to EMAP II.

In an alternate embodiment, the neutralizing compound may be an agonistof the CXCR3 receptor. The agonist may be a peptide, peptidomimetic orany other compound that disrupts the interaction between EMAP II and theCXCR3 receptor. In an illustrative embodiment, the neutralizing compoundis an EMAP II analog. Interruption of the binding of EMAP II to CXCR3may interfere with the detrimental action of EMAP II in lung tissue.

In yet another embodiment, the neutralizing compound may be a compoundor molecule that decreases the expression of EMAP II. Non-limitingexamples may be siRNA or antisense RNA targeted to EMAP II RNA or DNA.Alternatively, the neutralizing compound may be a compound or moleculesuch as, but not limited to, siRNA or antisense RNA, that interferes anddecreases the expression of CXCR3. As shown in FIG. 9, when human lungmicrovascular endothelial cells were electroporated in the presence ofCXCR3-targeting siRNA, CXCR3 expression levels showed reductions ofabout 60% to about 80%. As the nucleotide sequences are known for bothEMAP II and CXCR3, one skilled in the art would be able to select siRNAand/or antisense RNA sequences for EMAP II and/or CXCR3 without undueexperimentation. Examples of compounds and compositions for modulatingthe expression of EMAP II are disclosed in U.S. Patent ApplicationPublication No. 2004/0110114 and U.S. Pat. No. 5,665,593, both of whichare expressly incorporated by reference herein.

In one embodiment, protocols for the administration of the EMAP IIneutralizing compounds are similar to the protocols for theadministration of any other agent typically administered for a lungdisorder. As a general guideline, protocols developed for theadministration of any agent for the treatment of lung disease form astarting point for the administration of the EMAP II neutralizingcompounds of the present invention. Thus, the EMAP II neutralizingcompounds and compositions are administered via an inhalant or any othermechanism by which a disorder such as asthma is treated. In oneembodiment of the invention, the active compounds or pharmaceuticalformulations of the invention are administered directly to the lungs ofthe subject by any suitable means, but are preferably administered byadministering an aerosol suspension of respirable particles comprised ofthe active compound, which the subject inhales. The active compound canbe aerosolized in a variety of forms, such as, but not limited to, drypowder inhalants, metered dose inhalants, or liquid/liquid suspensions.The respirable particles may be liquid or solid. Alternatively, EMAP IIneutralizing compounds may be administered systemically, eitherintravenously or through other means known in the art.

Any of the protocols, formulations, routes of administration and thelike that have previously been used in the treatment of lung disordersmay readily be modified for use in the present invention. In some cases,mechanical ventilation is appropriate. Such ventilation may includehigh-frequency oscillatory ventilation (HFOV) or other unconventionalforms of mechanical ventilation. Theoretically, partial liquidventilation (PLV) offers the advantage of lung lavage combined withventilator support.

In another embodiment, the dosages are determined using an animal model,such as the EMAP II double transgenic models known to those of skill inthe art, and modified and adapted to use in higher mammals. The totaldose of therapeutic agent is administered in multiple doses or in asingle dose. In certain embodiments, the compositions are administeredalone, and in other embodiments the compositions are administered inconjunction with other therapeutics directed to the disease or directedto other symptoms thereof.

Regardless of the route of administration of the active compounds orformulations of the invention, the therapeutically effective dosage ofany one active compound, the use of which is in the scope of presentinvention, will vary somewhat from compound to compound, and patient topatient, and will depend upon factors such as the age, weight andcondition of the patient, and the route of delivery. Such dosages can bedetermined in accordance with routine pharmacological procedures knownto those skilled in the art. In one exemplary embodiment, a dosage fromabout 0.1 to about 50 mg/kg will have therapeutic efficacy, with allweights being calculated based upon the weight of the active compound.Toxicity concerns at the higher level may restrict intravenous dosagesto a lower level such as up to about 10 mg/kg. A dosage from about 10mg/kg to about 50 mg/kg may be employed for oral administration.Typically, a dosage from about 0.5 mg/kg to 5 mg/kg may be employed forintramuscular injection. Preferred dosages are 1 μmol/kg to 50 μmol/kg,and more preferably 22 μmol/kg and 33 μmol/kg of the compound forintravenous or oral administration.

In another exemplary embodiment, dosages of the compounds of the presentinvention, for antisense oligonucleotides the dosage is preferably onewhich produces intracellular concentrations of the oligonucleotide offrom 0.05 to 50 μM. Typically the dosage to a human will be from about0.01, 0.1 or 1 mg/Kg up to 50, 100, or 150 mg/Kg. In an additionalexample, for antibodies the dosage is typically 0.01, 0.05 or 0.1 mg/Kgup to 20, 40 or 60 mg/Kg.

When administration of the active compounds or pharmaceuticalformulations is via inhalation, the dosage of active compound will alsovary depending on the condition being treated and the state of thesubject, but generally may be an amount sufficient to achieve dissolvedconcentrations of active compound on the airway surfaces of the subjectof from about 10⁻⁹ to about 10⁻¹ Moles/liter, and more preferably fromabout 10⁻⁶ to about 10⁻⁴ Moles/liter.

Methods of formulating antibodies, peptides or other compounds fortherapeutic administration are known to those of skill in the art.Methods of formulating siRNA or antisense RNA are also known in the art.Administration of these compositions according to the present inventionwill be via any common route so long as the target tissue is availablevia that route. Most commonly, these compositions are formulated fororal administration, such as by an inhalant. However, other conventionalroutes of administration (e.g., by subcutaneous, intravenous,intradermal, intramusclar, intramammary, intraperitoneal, intrathecal,intraocular, retrobulbar, intrapulmonary (e.g., term release), aerosol,sublingual, nasal, anal, vaginal, or transdermal delivery, or bysurgical implantation at a particular site) are also used, particularlywhen oral administration is problematic. The treatment may consist of asingle dose or a plurality of doses over a period of time.

It will be appreciated by those skilled in the art that the compounds ofthe present invention can be employed in a wide variety ofpharmaceutical forms; the compound can be employed neat or admixed witha pharmaceutically acceptable carrier or other excipients or additives.Generally speaking, the compound will be administered orally orintravenously. It will be appreciated that therapeutically acceptablesalts of the compounds of the present invention may also be employed.The selection of dosage, rate/frequency and means of administration iswell within the skill of the artisan and may be left to the judgment ofthe treating physician. The method of the present invention may beemployed alone or in conjunction with other therapeutic regimens.

Upon formulation, solutions will be administered in a manner compatiblewith the dosage formulation and in such amount as is therapeuticallyeffective. The formulations are easily administered in a variety ofdosage forms such as inhalents, injectable solutions, drug releasecapsules and the like. For parenteral administration in an aqueoussolution, for example, the solution is suitably buffered if necessaryand the liquid diluent first rendered isotonic with sufficient saline orglucose. These particular aqueous solutions are especially suitable forintravenous, intramuscular, subcutaneous and intraperitonealadministration.

The frequency of dosing will depend on the pharmacokinetic parameters ofthe agents and the routes of administration. The optimal pharmaceuticalformulation will be determined by one of skill in the art depending onthe route of administration and the desired dosage. Such formulationsmay influence the physical state, stability, rate of in vivo release andrate of in vivo clearance of the administered agents. Depending on theroute of administration, a suitable dose is calculated according to bodyweight, body surface areas or organ size. The availability of animalmodels is particularly useful in facilitating a determination ofappropriate dosages of a given therapeutic. Further refinement of thecalculations necessary to determine the appropriate treatment dose isroutinely made by those of ordinary skill in the art without undueexperimentation, especially in light of the dosage information andassays disclosed herein as well as the pharmacokinetic data observed inanimals or human clinical trials.

Typically, appropriate dosages are ascertained through the use ofestablished assays for determining blood levels in conjunction withrelevant dose response data. The final dosage regimen will be determinedby the attending physician, considering factors which modify the actionof drugs (e.g., the drug's specific activity, severity of the damage andthe responsiveness of the patient, the age, condition, bodyweight, sexand diet of the patient, the severity of any infection, time ofadministration and other clinical factors). As studies are conducted,further information will emerge regarding appropriate dosage levels andduration of treatment for specific diseases and conditions.

In one embodiment of the present invention methods are provided formonitoring the effectiveness of treatment of a patient for emphysemaand/or COPD and undergoing treatment by determining the expressionlevels of EMAP II. The method may comprise the step of detecting EMAP IIin a patient's sample as described above. The method may furthercomprise comparing the EMAP II in the patient's sample with a control asdescribed above. Alternatively, the EMAP II expression levels may becompared to a sample from the same patient before treatment (i.e., fromdiagnosis) and/or samples from earlier in the treatment. In anillustrative embodiment, a method is provided comprising the steps ofdiagnosing a patient for emphysema and/or COPD by determining theexpression level of EMAP II, treating the patient if the diagnosis waspositive and monitoring the effectiveness of the treatment bydetermining the expression level of EMAP II during the treatment.

Example 1 Methods

Reagents and Antibodies.

All chemical reagents were purchased from Sigma-Aldrich (St. Louis,Mo.), unless otherwise stated. EMAP II antiserum was produced asrecently described (Knies, U. E., Kroger, S., and Clauss, M. 2000.Expression of EMAP II in the developing and adult mouse. Apoptosis5:141-151). Other antibodies employed were of commercial source,including MAC-3 (Becton Dickinson Biosciences, Franklin Lakes, N. J.),CXCR3 (R&D systems, Minneapolis, Minn.), and MMP-12 (R&D).

Cells.

Human lung microvascular endothelial cells (HLMVEC) were obtained fromLonza (Allendale, N.J.) and maintained in culture medium consisting ofEMB-2, 10% FBS, 0.4% hydrocortisone, 1.6% hFGF, 1% VEGF, 1% IGF-1, 1%ascorbic acid, 1% hEGF, 1% GA-100, and 1% heparin. All primary cellcultures were maintained at 37° C. in 5% CO₂ and 95% air. Experimentswere performed up to passage 10 with cells at 80-100% confluence.

Monoclonal Anti-EMAP II Antibody.

The rat monoclonal neutralizing antibody M7 against mouse EMAP II wasdeveloped by immunizing Lewis rats with recombinant murine pro-EMAP II.Lymphocytes isolated from the spleen and lymph nodes of immunized ratswere fused with the mouse myeloma SP2/0, and Clones were selected bytesting hybridoma supernatants in ELISA for binding both pro- and matureEMAP II. The clones most active in ELISA were further characterized byWestern blotting and neutralization of EMAP II-induced endothelialapoptosis in tissue culture experiments (manuscript in preparation). Forpurification of MoAbs for in vivo studies, hybridomas were grown inprotein-free hybridoma medium (GIBCO-BRL) and antibodies were purifiedwith protein G-Sepharose (Pharmacia, Uppsala, Sweden).

Animal Studies.

C57/B16 mice were purchased from Jacksons Lab. A lung-specific inducibleEMAP II transgenic mouse was generated by crossing the EMAP II respondermouse with homozygous transgenic mice containing the transactivatorcontrolled by the lung epithelium specific CCSP. The EMAP II respondertransgenic mouse contained the secreted (mature) form of EMAP II under aminimal promoter containing tetracycline-inducible sequences. Thereforethe murine mature EMAP II cloned from meth mouse tumor cells (Knies, U.E., Behrensdorf, H. A., Mitchell, C. A., Deutsch, U., Risau, W.,Drexler, H. C., and Clauss, M. 1998. Regulation of endothelialmonocyte-activating polypeptide II release by apoptosis. Proc Natl AcadSci USA 95:12322-12327) and fused to a signal peptide derived from INFbwas inserted into the tet-repeat containing plasmid pUD10-3 by using SacII and Xho I insertion sites. The resulting plasmid was injected intooocytes for implantation into foster mice and a transgenic line wasestablished. After crossing of the resulting responder mice with thertTA transactivator mice, the first generation of mice heterozygous forthe EMAP II responder transgene were compared to the CCSP transactivatorwith CCSP transactivator-only transgenic mice. Of note, only the EMAPII/CCSP transactivator but not the CCSP transactivator-only transgenecan induce EMAP II expression. With this design, CCSP transactivatorbackground effects and tetracycline effects can be ruled out, as bothgroups can be treated with tetracycline. Transgenic mice were bred in anAAALAC accredited animal facility. Double transgenic EMAP II/CCSP-rtTAand single transgenic CCSP-rtTA mice were maintained on regular wateruntil 3 to 4 month of age. Thereafter, the mice were placed ondoxycycline treatment for up to 6 months. At the end of experiments, themice were euthanized and the tissue was processed as described(Petrache, I., Natarajan, V., Zhen, L., Medler, T. R., Richter, A. T.,Cho, C., Hubbard, W. C., Berdyshev, E. V., and Tuder, R. M. 2005.Ceramide upregulation causes pulmonary cell apoptosis and emphysema-likedisease in mice. Nat Med 11:491-498). In addition, mice underwent BALwith 0.6 ml of PBS thrice. BAL cells were sedimented via centrifugationand the acellular fluid was then snap-frozen in liquid nitrogen andstored at −80° C. for further analysis.

Cigarette Smoke Exposure.

Cigarette smoke exposure was performed as previously described (Cavarra,E., Bartalesi, B., Lucattelli, M., Fineschi, S., Lunghi, B., Gambelli,F., Ortiz, L. A., Martorana, P. A., and Lungarella, G. 2001. Effects ofcigarette smoke in mice with different levels of alpha(1)-proteinaseinhibitor and sensitivity to oxidants. Am J Respir Crit Care Med164:886-890). Mice (C57/B16 mice, female, age 12 weeks; n=5-10 pergroup) were exposed to cigarette smoke or ambient air for up to 24weeks. In a separate experiment, double transgenic EMAP II/CCSPtransactivator or single transgenic CCSP transactivator controllittermates, male and female, age 12 weeks; n=5-10 per group wereexposed to cigarette smoke or ambient air by a similar protocol asabove. Prior to (for the duration indicated) and during the cigarettesmoke exposure, all transgenic mice received water with doxycycline. Ina separate experiment, mice (DBA2, female, age 12 weeks; n=5-12 pergroup) were exposed to cigarette smoke as described above or ambient airfor four months; during the third month of cigarette smoke exposure, twogroups of mice exposed to cigarette smoke received either EMAP IIantibody by nebulization or isotype IgG control, and one group exposedto ambient air received isotype IgG control. The day following the endof the cigarette smoking schedule in all experiments mice wereeuthanized and lung processing was performed as previously described(Petrache, I., Natarajan, V., Zhen, L., Medler, T. R., Richter, A. T.,Cho, C., Hubbard, W. C., Berdyshev, E. V., and Tuder, R. M. 2005.Ceramide upregulation causes pulmonary cell apoptosis and emphysema-likedisease in mice. Nat Med 11:491-498).

VEGF Receptor Blockade.

VEGF receptor blockade was performed as previously described (Petrache,I., Natarajan, V., Zhen, L., Medler, T. R., Richter, A. T., Cho, C.,Hubbard, W. C., Berdyshev, E. V., and Tuder, R. M. 2005. Ceramideupregulation causes pulmonary cell apoptosis and emphysema-like diseasein mice. Nat Med 11:491-498). Mice (n=4-6/group) were injected withSU5416 (Calbiochem; 20 mg/kg, subcutaneously) or vehicle(carboxymethylcellulose) and the mice were euthanized at the indicatedtime.

Morphometric analysis was performed on coded slides as described, usinga macro developed by R.M.T. for Metamorph (Tuder, R. M., Zhen, L., Cho,C. Y., Taraseviciene-Stewart, L., Kasahara, Y., Salvemini, D., Voelkel,N. F., and Flores, S. C. 2003. Oxidative stress and apoptosis interactand cause emphysema due to vascular endothelial growth factor receptorblockade. Am J Respir Cell Mol Biol 29:88-97; Aherne, W. A., andDunnill, M. S. 1982. Morphometry. London: E. Arnold. xiv, 205 pp).

Human Lung Tissue.

Human lung tissue consisted of sections from fixed, paraffin embeddedexplanted lung tissue from COPD patients and patients without lungdisease (collected at the Johns Hopkins University). The specimencollection and storage were approved by the Institutional Research Boardfrom the Johns Hopkins University.

Apoptosis was detected in lysates (Petrache, I., Natarajan, V., Zhen,L., Medler, T. R., Richter, A. T., Cho, C., Hubbard, W. C., Berdyshev,E. V., and Tuder, R. M. 2005. Ceramide upregulation causes pulmonarycell apoptosis and emphysema-like disease in mice. Nat Med 11:491-498)or inflated fixed lung sections enabling focus on alveoli, rather thanlarge airways and vessels (Tuder, R. M., Zhen, L., Cho, C. Y.,Taraseviciene-Stewart, L., Kasahara, Y., Salvemini, D., Voelkel, N. F.,and Flores, S. C. 2003. Oxidative stress and apoptosis interact andcause emphysema due to vascular endothelial growth factor receptorblockade. Am J Respir Cell Mol Biol 29:88-97), via active caspase-3 IHC(Abcam and Cell Signaling) or in situ labeling of apoptotic DNA onmurine lung, using rat serum as negative control. The immunostaining forboth active caspase-3 and TUNEL was followed by DAPI (Molecular Probes)nuclear counter-staining. Executioner caspase (caspase-3 and/or -7)activity was measured with ApoONE Homogeneous Caspase-3/7 assay kit(Promega, Madison, Wis.). Human recombinant caspase-3 (Calbiochem) wasutilized as positive control.

Lipid Extraction and Ceramide Species Measurement by Tandem MassSpectroscopy.

Cellular or lung tissue lipids were extracted and lipid content wasassessed by measurements of total lipid phosphorus (P_(i)) (Petrache,I., Natarajan, V., Zhen, L., Medler, T. R., Richter, A. T., Cho, C.,Hubbard, W. C., Berdyshev, E. V., and Tuder, R. M. 2005. Ceramideupregulation causes pulmonary cell apoptosis and emphysema-like diseasein mice. Nat Med 11:491-498). After lipid extraction, the followingindividual molecular species of ceramides were monitored: 14:0, 16:0,18:0, 18:1, 20:0, 24:0, and 24:1-ceramides and utilizing C₁₇ ceramide asinternal standard, ceramides were measured by combined liquidchromatography-tandem mass spectrometry (LC-MS/MS).

IHC.

Paraffin sections were blocked with 10% rabbit (or goat serum ifsecondary antibody from goat) and incubated with antibodies or controlantibodies. Polyclonal rabbit antiserum included EMAP II (1:500 dilute),caspase-3 (Cell signaling) and anti-MMP-12 (1:100, Sigma). Boundantibody was detected according to the manufacturer's instructions or abiotin-conjugated goat anti-rat IgG secondary antibody (Dianova, 1:100)and Streptavidin-coupled phycoerythrin (Dianova, 1:1000). For someapplication (anti-CD144, Pharmingen) cryosections were used. Sectionswere counterstained with DAPI and mounted with Mowiol 488 (Calbiochem).Microscopy was performed on either a Nicon Eclipse (TE200S) invertedfluorescent or a combined confocal/multi-photon (Spectraphysics laser,BioRad MRC1024MP) inverted system. Images and quantitative intensity(expression) data were processed by MetaMorph Imaging software(Universal).

Western Blotting.

Lung tissue was homogenized in RIPA buffer with protease inhibitors onice and proteins were isolated by centrifugation at 10,000 g for 10minutes at 4° C. BAL supernatants from transgenic mice or patients werecollected and proteins were concentrated and precipitated by addition oftrichloroacetic acid. Proteins were loaded in equal amounts (10 mg,unless otherwise noted) as determined by BCA protein concentration assay(Pierce, Rockville, Ill.). Total proteins were separated by SDS-PAGEusing Novex gels (Invitrogen, Carlsbad, Calif.), followed byimmunoblotting for EMAP II as previously described (Knies, U. E.,Behrensdorf, H. A., Mitchell, C. A., Deutsch, U., Risau, W., Drexler, H.C., and Clauss, M. 1998. Regulation of endothelial monocyte-activatingpolypeptide II release by apoptosis. Proc Natl Acad Sci USA95:12322-12327). Briefly, samples were mixed with Laemmli buffer, boiledat 95° C. for 10 min and loaded onto 15% SDS/PAGE gels. Proteins wereseparated by electrophoresis and blotted onto nitrocellulose (Pierce)using a semidry blotting apparatus. Unspecific binding was reduced byblocking the membrane in TBS/0.1% Tween 20/5% nonfat dry milk. Theprimary antibody (rabbit anti-EMAP II antiserum SA 2847, diluted 1:1000in TBS/0.1% Tween 20/5% BSA) was applied overnight at 4° C. Afterwashing, the membranes were incubated in a peroxidase-coupled goatanti-rabbit IgG (Dianova/Jackson Immuno Research; diluted 1:3500 inblocking buffer) for 1 h at room temperature and developed using anenhanced chemilluminescence kit (Amersham Pharmacia Biotech)Immunoblotting for EMAP II in lung lysates or BAL was performed byincubation with EMAP II-specific antibody (rabbit serum, produced asdescribed above) in a 1:250 dilution in TBST for 1 h at roomtemperature. The chemiluminescent signals were quantified bydensitometry (ImageQuant; Amersham, Piscataway, N.J.) and normalized byhousekeeping proteins (actin, GAPDH, or vinculin).

Statistical analysis was performed with SigmaStat software using ANOVAwith Student-Newman-Keuls post hoc test. Statistical difference wasaccepted at p<0.05.

Example 2 Effect of Cigarette Smoke Exposure or VEGF Receptor Inhibitionon EMAP II Expression in the Mouse Lung

To test the hypothesis that smoking induces cellular stress causingrelease of EMAP II, the effect of smoking on EMAP II protein productionwas measured. The extent of apoptosis induced by cigarette smoking inthe mouse lung was also assessed. To more specifically address thecorrelation between endothelial cell death and EMAP II overproduction,the lung EMAP II expression in mice treated with a VEGF receptorblocker, which induces endothelial cell apoptosis was tested.

Mice susceptible to cigarette smoke-induced emphysema were exposed tocigarette smoke for various periods of time, from 4 days to 6 months.EMAP II expression was measured in lung lysates by Western blotting andapoptosis by caspase-3 activity and ceramide production. Finally, lungsfrom mice treated with VEGF receptor blocker SU5416 (20 mg/kgsubcutaneously) were tested for EMAP II expression by Western blottingat 3 weeks, a time when lungs typically show morphometric changes ofemphysema.

Cigarette smoke CS exposure for 4 days increased caspase-3 activity inlungs, and thus increased apoptotic activity as early as 1 week aftercigarette smoke exposure in C57/B16 mice (FIG. 2A), long preceding theincreases in airspaces typical of emphysema that occurred at 6 months ofcigarette smoke exposure (FIG. 2C). At 1 month the lung content ofceramide increased in DBA 2 mice (FIG. 2B). These early increases inapoptotic activity were paralleled by an increase in both the pro- andmature forms of EMAP II expression (FIGS. 3A and 3B). Similarly, inanother experimental model of apoptosis-dependent emphysema, SU5416induced a robust EMAP II expression at 4 weeks in the C57/B16 mouse lung(FIG. 3C).

These results suggest an increase in apoptotic rates and EMAP IIproduction in the emphysematous lungs of mice, including those exposedto cigarette smoke. While not wishing to be bound by theory, theincrease in EMAP II may result from direct cell stress, or fromapoptosis-activated caspases. Furthermore, EMAP II release may itself beresponsible for inducing further lung endothelial cell apoptosis.

Example 3 Effect of Elevated Lung EMAP II Levels on the Severity ofCigarette Smoke-Induced Injury in the Mouse Lung

To test whether increases in EMAP II have an additive or a synergisticeffect with cigarette smoking in the lung, EMAP II expression in thelungs was induced for 8 weeks prior to cigarette smoke exposure. Theconditional transgenic overexpression system is presented in more detailin Example 4.

An increase in baseline EMAP II levels in the lung followed by a 4 weekcigarette smoke exposure profoundly elevated the levels of mature EMAPII and increased the number of inflammatory cells in theinter-alveolar/interstitial tissue consistent with a further increase inparenchymal inflammation compared to smoking alone.

These results suggest that EMAP II contributes to cigarettesmoke-induced lung injury and may independently worsen or predispose thelung to a more severe inflammatory response to smoke.

Example 4 Transgenic Induction of EMAP II in the Lung CausesEmphysema-Like Disease in Mice

To study the mechanism by which increased lung levels of EMAP II triggeremphysema, a transgenic murine model of inducible expression of EMAP IIin the lung was established using the tetracycline inducibletransactivator (TTA) controlled by the lung epithelium-specific CCSPpromoter. Although both EMAP II forms were available as inducibleconstructs, the mature EMAP II was initially assessed since it has beenclassically involved in the apoptosis and inflammatory effects of EMAPII. Furthermore, the pro-EMAP II is usually easily cleaved to generatemature EMAP II, making it difficult to assess its specific,mature-form-independent effects.

The transgenic mouse tet EMAP II (responder mouse) contained the matureform of EMAP II under a minimal promoter containingtetracycline-inducible sequences. This mouse line does not expresselevated levels of EMAP II because it lacks the transactivator geneproduct. The responder mouse was crossed with homozygous transgenic micecontaining the transactivator controlled by the lung epithelium specificCCSP promoter (CCSP mouse line), which in this form targets geneexpression predominately in alveolar type II cells versus in Claracells. Clark, J. C., et al. Am J Physiol Lung Cell Mol Physiol 280,L705-715 (2001); Li, Y., et al. Cancer Res 67, 8494-8503 (2007). Thefirst generation of mice heterozygous for the EMAP II respondertransgene and the CCSP transactivator with CCSP transactivator-onlytransgenic mice were compared. Of note, this CCSP transactivator-onlytransgene cannot induce EMAP II overexpression. With this design, CCSPtransactivator background effects as described recently (Sisson, T. H.,et al. Am J Respir Cell Mol Biol 34, 552-560 (2006)) and tetracyclineeffects can be ruled out, as both groups were treated with tetracycline.Furthermore, the tetracycline concentration used in this inductionsystem is insufficient to ameliorate any inflammation and MMPactivities. Expression was analyzed by Western of BAL and lung lysatesand by IHC of lung sections using EMAP II antiserum. To determinewhether long term EMAP II over-expression in the lung induces anemphysema-like phenotype, double transgenic mice with tetracycline inthe drinking water were treated for up to 6 months.

Transgenic induction of EMAP II caused high EMAP II secretion into thelungs of double transgenic mice after as early as 24 h (FIGS. 3B, 4B and5A). Of note, the EMAP II expression pattern in the lung parenchymaresembled typical staining pattern for alveolar type II cells, which isin line with the reported selectivity for this transgenic promoter. EMAPII double transgenic mice treated for 3 or 6 months with tetracycline toinduce EMAP II expression displayed significant emphysema-like increasein airspace (FIG. 7A). This was measured both by the mean linearintercept and the recently established method of volume-weighted meanairspace volume. Morphological parameters for emphysema appear toincrease proportional to the duration of EMAP II induction, which isreflected by morphometry: the volume-weighted mean airspace volume was1.36E+08±0.15, n=5 in control mice; 1.56E+08±0.3 in EMAP II transgenicmice induced for 3 months; and 1.91E+08±0.3, n=6, in those induced for 6months; p=0.027)

Increased EMAP II production in the lungs leads to formation ofemphysema-like morphological changes. This is the first evidence thatexcessive levels of a protein causing endothelial cell death leads toemphysema.

Example 5 Excessive EMAP II Production in the Lung Causes Pulmonary CellApoptosis

To address the hypothesis that EMAP II over-production promotesemphysema via endothelial cell apoptosis, apoptosis in the lungs of EMAPII-overexpressing mice was assessed. To determine the EMAPII-specificity of apoptosis, and to test in vivo the efficacy of an EMAPII-neutralizing antibody, the anti-EMAP antibody was administered to agroup of EMAP II transgenic animals.

Fluorescent microscopy with specific active caspase-3 antibody of lungsections from EMAP II/CCSP double transgenic (EMAP II tg) or CCSPcontrol transgenic animals (ctl) was used to detect the presence andlocalization of apoptosis in the lung. Anti-VE-cadherin antibody wasused to test for colocalization of apoptosis with endothelial cells. Inaddition, lung lysates were tested for caspase-3 activity byfluorimetric enzymatic assay (Promega). For the neutralizationexperiment, EMAP II tg (induced for 48 h before harvesting the lungs)received anti-EMAP II rat monoclonal antibody or isotype IgG control, bya single injection i.p., 12 h after the induction.

EMAP II significantly increased the number of caspase-3 positive cellsin the lung parenchyma of EMAP II tg versus ctl (−6 fold, p=0.003, byfluorescence quantitation using Metamorph on blinded slides) as early as3 weeks after induction. The increased lung apoptosis persisted after 3months and 6 months of EMAP II inductions as assessed by both IHC andcaspase-3 activity from lung lysates (FIGS. 6A and 6B). The majority ofcaspase-3 positive cells were endothelial cells. There was a trend fordecreased apoptosis in mice receiving neutralizing EMAP II antibody(FIG. 6C).

It is thought that changes by in situ detection of activated caspase-3were more dramatically significant due to the higher signal to noiseratio in lysates resulting from having many other non-dying cells otherthan endothelial cells. Finally, although not yet statisticallysignificant, the neutralizing effects of anti-EMAP II antibody areextremely encouraging in that apoptosis observed is EMAP II dependentand that the neutralizing antibody is effective in vivo. Taken togetherthese data support the conclusion that endothelial cell apoptosis may bea key event in EMAP II-induced emphysema formation.

Example 6 Effect of Lung-Specific EMAP II Overexpression on the MonocyteRecruitment in the Lung

It was previously shown that EMAP II attracted and activated monocytesin a dose-dependent manner, caused inflammation when locally injected,and triggered leukostasis in the lung upon systemic application. Kao,J., et al., J Biol Chem 269, 25106-25119 (1994); Kao, J., et al., J BiolChem 269, 9774-9782 (1994). The chemotactic effect of EMAP II onmonocytes may be important in the inflammatory responses associated withemphysema.

Confocal imaging of fluorescent immunostaining of markers for lungmacrophage accumulation and activation in lung sections from EMAPII/CCSP double transgenic vs. CCSP single transgenic animals wasperformed using MAC-3-(macrophage marker) as well as TNFα-, MMP-9-, andMMP-12-specific antibodies.

The lung specific overexpression of mature EMAP II dramaticallyincreased the numbers of MAC-3-expressing cells along with staining forTNFα-, MMP-9, MMP-12 in the lung (FIGS. 7A and 7B). The vast majority ofTNFα-, MMP-9, MMP-12 and MAC-3 positive cells displayed a large nuclearphenotype, characteristic for macrophages, whereas MMP-12-positivitycolocalized not only with Mac-3 (FIG. 7A), but also with other cellswithin the alveolar wall, possibly epithelial cells.

The increase in Mac-3 positive cells was most likely due to recruitmentof monocytes form the circulation to the lung, as the proliferationcapacity of already resident lung macrophages is extremely low. Thesemacrophages may be a source of inflammatory activation in the lungs ofEMAP II transgenic.

Example 7 Both Pro- and Mature EMAP II-Induce Significant Apoptosis inHuman Primary Microvascular Lung Endothelial Cells

Situations associated with stress can induce both forms of EMAP II. Itis not known which form is more potent in inducing endothelial cellapoptosis and whether the mechanism by which this occurs isform-dependent. These detailed mechanistic assays can only be done incell cultures. However to increase their significance, only primary lungmicrovascular endothelial cells of human origin, commercially obtained(Lonza) were tested.

Primary human lung microvascular endothelial cells were treated withrecombinant pro- or mature-EMAP II at 10-16 μg/ml. Apoptosis wasmeasured by caspase-3 activity and Annexin/PI staining by flowcytometry. Treatment with both forms of EMAP II resulted in increasedapoptosis as measured by caspase-3 activity (FIG. 8A) and Annexin/PIstaining (FIG. 8E).

Both the pro- and mature EMAP II forms appeared equally potent atinducing endothelial cell apoptosis in culture conditions.

Example 8 The Stress-Sensitive CXCR3 Receptor Mediates EMAP II-InducedLung Endothelial Cell Apoptosis

To investigate whether the CXCR3 receptor mediates EMAP II-induced lungendothelial cell apoptosis, its expression on primary human lungmicrovascular endothelial cells was initially assessed and secondly, itsfunction was inhibited by specific blocking antibodies.

Primary human lung microvascular endothelial cells were cultured innormal growth media, as well as in media containing low serumconcentration (2%), or even treated with acellular BAL from smoked orcontrol mice. The BAL was concentrated (50-fold) and cells wereincubated with a volume representing 10% of the original undilutedcellular BAL. CXCR3 was detected by using labeled anti-CXCR3 antibodydetected by FACS. To assess the role of the CXCR3 caspase-3 activationin lung microvascular endothelial cells, cells with blocking anti-CXCR3antibodies were pretreated (1 ng/ml, pretreated for 30 min).

Primary human lung microvascular endothelial cells express CXCR3 at lowlevels. Stressful conditions such as serum starvation, treatment withBAL from smoked but not from non-smoked mice, or even electroporation(FIG. 9) increased significantly its expression (FIGS. 8A-8D).Anti-CXCR3 antibodies, but not isotype IgG antibodies significantlyreduced mature EMAP II-induced endothelial cell death (FIGS. 8A-8D).

These results are strong evidence that EMAP II-induced endothelial cellapoptosis in the lung may be mediated primarily by the CXCR3 receptor.This implies that CXCR3 mediates the functional effects of EMAP II onboth endothelial cells and monocytes and may be important for thedevelopment of cigarette smoke emphysema.

Example 9 Cigarette Smoke Increased the Expression of Both EMAP II Formsin the Mouse Lung

Based on previous findings that mature EMAP II is released by apoptosisand the proform upon stress, the induction of EMAP II in the lung invivo upon exposure to cigarette smoke was investigated. Therefore, EMAPII expression was measured in two inbred mouse strains, C57/B16 andDBA2, which reportedly develop emphysema after chronic exposure tocigarette smoke for 6 or 4 months, respectively. Cigarette smokeexposure (CSE) (for up to 24 weeks) profoundly increased both the pro-and mature forms of EMAP II (approximately 8- and 2-fold, respectively)secreted in the BAL and detected by Western blotting (FIG. 10A). Equalvolume (100 μl) of acellular BAL from each mouse was pooled (n=5 pertime point), then equally concentrated (10×) and equally loaded (10 μl)in each lane. Specific EMAP II antibody (1:250) detected both the pro-and the mature forms of the EMAP II in the lavage. BAL from the EMAP IIoverexpressing transgenic (Tg) mice was utilized as positive (Pos)control. Similar increases in the two forms of EMAP II expression werenoted in the lung parenchyma of DBA2 mice exposed to cigarette smoke for4 weeks (FIG. 10B).

Interestingly, in a distinct experimental model of apoptosis-dependentmurine emphysema which develops secondary to VEGF receptor inhibition,EMAP II expression was also markedly upregulated in the lungs of micewhich developed airspace enlargement compared to control mice, butpredominantly in the pro-form (FIG. 10C). FIG. 10C shows EMAP IIexpression in the lung parenchyma of C57/B16 mice at four weeks aftertreatment with the VEGF receptor inhibitor (VEGFR-inh). Each lane wasloaded with 40 mg lung lysate from individual mice treated with vehicle(carboxymethyl cellulose) or the VEGFR-inh SU5416 (20 mg/kg,subcutaneous). Vinculin was immunoblotted as loading control. Thekinetics of EMAP II elevation in response to cigarette smokingdemonstrated that the increase in lung EMAP II secretion preceded thatof alveolar macrophage accumulation, first noted at 4 weeks, but not 2weeks of cigarette smoke exposure (FIG. 10D). The kinetic relationshipof the EMAP II increase with the caspase-3 activation in the lung wasmore complex, as significant caspase-3 activation was noted throughoutthe time course of the EMAP II increases in response to cigarettesmoking in mice (FIG. 10E). Since EMAP II's biological propertiesinclude monocyte chemoattraction and apoptosis of proliferative andhypoxic endothelial cells, EMAP II could play an important role in theinflammatory and apoptotic responses in the lung in response tocigarette smoke exposure.

Example 10 Neutralization of Pro and Mature-EMAP II-Induced EndothelialCell Apoptosis

Because mature EMAP II has been shown to induce endothelial apoptosis,it was investigated whether a rat antibody hybridoma clone M7/1 (M/71antibody) was also able to neutralize apoptosis induced by EMAP II. Inparticular it was investigated whether this M7/1 antibody was able toneutralize pro-apoptotic activities of both pro- and mature EMAP II.

EMAP II induced apoptosis was assessed by quantification ofTUNEL-positive cells (FIG. 11A). Endothelial cells incubated withpro-EMAPII protein (50 μg/ml) or mature-EMAPII protein (50 μg/ml)demonstrated a significant apoptosis (arrows) as shown by TUNEL(*p<0.01). Pretreatment of these cells with the neutralizing M 7/1antibody (10 μg/ml), but not with control rat IgG, significantly(**p<0.03) inhibited apoptosis induced by both pro and mature EMAPII asshown from representative fluorescent microscope images following TUNELassay. Quantification of TUNEL positive cells by MetaMorph softwarenormalized to total DAPI nuclear positive cells is also shown forpro-EMAPII (FIG. 11B) and mature EMAPII (FIG. 11C). Data shown are froma representative experiment performed in triplicates and repeatedindependently two additional times with similar results. Scale bar=50μm.

Thus, EMAP II induced apoptosis was significantly (p<0.03) blocked bythe anti-EMAP II M 7/1 antibody, but not by control rat IgG (FIGS.11A-11C). Interestingly, it was observed that pro-EMAP II at the samemolar concentrations as mature EMAP II was also a strong inducer ofendothelial apoptosis. Again, the M 7/1 antibody was able to completelyneutralize this activity (p<0.01). These data demonstrate that the M7/1antibody can effectively neutralize the pro-apoptotic function of bothEMAP II forms and may be a suitable tool to inhibit pathophysiologicalactivities of this protein in mice. (Rajashekhar, G. et al, A monoclonalrat anti-mouse EMAP II antibody that functionally neutralizes pro- andmature-EMAP II in vitro, J Immunol Methods. 2009 Oct. 31; 350(1-2):22-28).

Example 11 Neutralization of EMAPII Levels Markedly Reduces CS-InducedLungemphysema in Mice

Because EMAPII has been shown to be produced and released by apoptosis,hypoxia, and cellular stress, it was investigated whether EMAPII isinduced in the lung in vivo upon exposure to cigarette smoke (CS).EMAPII protein expression was measured in the DBA/2 mouse strain, whichdevelops emphysema after chronic exposure to CS as early 16 weeks,exhibiting a 20% increase in airspace size, compared with only a 9%increase measured in the C57BL/6 strain at this time point,respectively. CS exposure for only 4 weeks significantly increased thepro and mature forms of EMAPII expression in the lung parenchyma ofDBA/2 mice compared with that in control mice exposed to ambient air(air control [AC]), measured by immunoblotting (FIG. 12A).

Next, the cellular localization of EMAPII expression in normal andCS-exposed mice was investigated by coimmunofluorescence with EMAPIIantiserum, CD11b antibody, and DAPI. Under ambient air conditions, lungsof control mice showed sparse EMAPII expression that colocalized mostlywith CD11b-labeled alveolar macrophages (FIG. 12B, left panel). Bycontrast, cigarette smoking robustly increased both intracellular andextracellular EMAPII production, which colocalized with both macrophages(FIG. 12B, middle panel) and alveolar septal cells (FIG. 12B, rightpanel).

The M7/1 antibody from Example 10 was used to functionally assess therole of the secreted EMAPII in CS-induced lung injury and emphysema. TheM7/1 antibodies (50 μg/application) were administered directly to thelung via inhalation of a nebulized solution, which showed effectivedeposition in the lung parenchyma at 15 minutes by fluorescencemicroscopy of the lung and at 4 hours by immune adsorption analysis ofrecovered biotinylated antibody from plasma. This method ofadministration has the advantages of targeting the local EMAPII pool andhas been previously shown to allow the use of lower antibody dosescompared with the systemic route. The timing of M7/1 antibody deliverywas chosen to follow the increases in EMAPII detected in response to CSexposure, while the duration of antibody M7/1 treatment was limited to 4weeks to minimize or avoid nonspecific immunological side effects. DBA/2mice were first exposed to CS alone for 8 weeks, followed by targetingEMAPII with neutralizing M7/1 antibodies between weeks 9 to 12 and 4additional weeks of CS exposure (FIG. 12C).

The administration of EMAPII-neutralizing M7/1antibody significantlydecreased lung apoptosis measured by caspase-3 activity in tissuelysates (FIG. 12D). In addition, this treatment decreased the number ofinflammatory cells retrieved in the BALF (FIG. 12E), particularlyalveolar macrophages and neutrophils, and reduced the number ofneutrophils in the lung parenchyma. Furthermore, anti-EMAPII M7/1antibodies significantly improved the lung static compliance (FIG. 12F)by almost 40%. Importantly, consistent with these functional data,neutralization of EMAPII abolished the CS-induced airspace enlargementmeasured as a 19.4% increase in MLI compared with that in air-exposedmice, which is in a typical range for CS-induced emphysema mouse models(FIGS. 2G and 2H). Interestingly, neutralizing EMAPII antibodies had noeffect on CS-induced large airway epithelial remodeling but restored thethickness of the epithelial layer of small airways (smaller than 150 μmin diameter), which was significantly reduced by CS exposure. (Clauss,M. et al., Lung endothelial monocyte-activating protein 2 is a mediatorof cigarette smoke-induced emphysema in mice, J Clin Investdoi:10.1172/JCI43881).

Example 12 Lung-Specific EMAP II Overexpression Induced Emphysema-LikePathology of the Lung

Endothelial cell death, alveolar macrophage accumulation and MMP-12expression are implicated in emphysema pathogenesis. Lung-specific EMAPII overexpression for up to 6 months significantly increased airspacediameters, consistent with simplification of alveolar structures (FIGS.5B-5E). The airspace enlargement was progressive, noted onhematoxyllin-eosin stained lung sections and measured by thevolume-weighted mean airspace volume, which significantly increased from1.36E+08 (±0.15, n=5) in control mice to 1.56E+08 (±0.3 SD, n=6) at 3months (not shown) and 1.91E+08 (±0.3, n=6) at 6 months of EMAP II lungoverexpression (p=0.027) (FIG. 5E). The loss of alveolar septae wasfurther supported by an increase in the mean linear intercept in themice overexpressing EMAP II for 3 months compared to control mice (FIG.5C). Note that the bar in FIGS. 5B and 5D represents 300 μm. These datasuggest that EMAP II increase alone may be sufficient to triggeremphysema-like airspace enlargement.

Example 13 Specific Neutralization of Secreted EMAP II InhibitsCigarette Smoke-Induced Airspace Enlargement in Mice

To investigate whether an excess of secreted EMAP II is also necessaryfor the pathogenesis of airspace enlargement in response to cigarettesmoking, EMAP II was neutralized by administration of specificmonoclonal antibodies in mice exposed to cigarette smoking. The DBA2mice, which develop significant airspace enlargement after 4 months ofcigarette smoke exposure, were first exposed to cigarette smoke for 2months. For the following 1 month of exposure, specific EMAP IIantibodies or isotype IgG (1 mg/kg) were administered thrice weekly vianebulization. At the end of the 4 month of total cigarette smokeexposure, lung morphometry demonstrated significant increase in airspacesize consistent with simplification of alveolar structure, reminiscentof emphysema, in response to smoking but not ambient air (FIG. 12G, leftpanel and middle panel, bar is 100 μm). While inhaled IgG did not havean inhibitory effect on cigarette smoke-induced airspace size (notshown), treatment of mice with inhaled EMAP II antibody significantlyinhibited the airspace enlargement induced by cigarette smoking (FIG.12G, right panel, and FIG. 12H). These data suggest that application ofneutralizing antibodies can reduce emphysema development even after aconsiderable time of smoke exposure.

Example 14 Synergistic Effects of EMAP II and Cigarette Smoke Exposurein the Lung

Having shown that EMAP II is both sufficient and necessary in smokeinduced emphysema, it was next asked whether enhanced levels of baselineEMAP II in the lung sensitize the lungs to cigarette smoke-inducedinjury, specifically apoptosis and macrophage inflammation. Increasedlung levels of EMAP II were achieved in the double transgenic mice bytetracycline administration for 8 weeks. Double transgenic (EMAP IIoverexpressing) or single transgenic control mice were then exposed tocigarette smoking daily, five times a week, for 4 weeks. Lungs were thenassessed for levels of apoptosis by extracting and measuring whole lungapoptosis-signaling ceramides, as reported previously (Petrache, I.,Natarajan, V., Zhen, L., Medler, T. R., Richter, A. T., Cho, C.,Hubbard, W. C., Berdyshev, E. V., and Tuder, R. M. 2005. Ceramideupregulation causes pulmonary cell apoptosis and emphysema-like diseasein mice. Nat Med 11:491-498). At this time point of cigarette smokeexposure, lungs of wild-type mice express only modest increases inceramides (Petrache, I., Medler, T. R., Richter, A. T., Kamocki, K.,Chukwueke, U., Zhen, L., Gu, Y., Adamowicz, J., Schweitzer, K. S.,Hubbard, W. C., et al. 2008. Superoxide dismutase protects againstapoptosis and alveolar enlargement induced by ceramide. Am J PhysiolLung Cell Mol Physiol 295:L44-53). Interestingly, there was a dramaticincrease in ceramides in the lungs of mice overexpressing EMAP II priorto cigarette smoking compared to either EMAP II overexpression orcigarette smoking alone (FIG. 4A). Similarly the number of lungmacrophages measured by IHC using F4/80 antibody increasedsynergistically in the mice overexpressing EMAP II prior to cigarettesmoking compared to mice exposed for the same duration to eitherstimulus alone. Levels of lung ceramide (FIG. 2C), a marker of alveolarapoptosis elevated in emphysema were measured by tandem massspectrometry and levels were normalized for lipid phosphorus (Pi)content. Horizontal lines represents median and whiskers depict the5^(th) and 95^(th) percentile. Groups were compared by ANOVA; *p=0.01 vscontrol; **P=<0.006 vs. control and vs. control+cigarette smoke. H&Estaining showed increased inflammatory cells in CS-exposed mice which isfurther aggravated in Tg mice exposed to CS. These data provide evidencefor the hypothesis that EMAP II may be a predictor and mediator ofemphysema formation.

Example 15 EMAP II Elevations in Human Lungs with COPD and in theBroncho-Alveolar Lavage of Smokers

To investigate the relevance of increased lung EMAP II levels for humanemphysema, EMAP II in subjects diagnosed with emphysema was assessed.Immunostaining (IHC) of lung samples obtained from patients withemphysema at the time of lung transplantation with specific EMAP IIantibody demonstrated markedly increased EMAP II staining compared withnon-diseased lungs. Interestingly, variable levels of EMAP II expressionwere noted in individuals without a diagnosis of COPD at the time oftissue sampling. This variability may be related to smoking status, asthe BAL obtained from active smokers without a COPD diagnosis exhibitedincreased EMAP II levels compared to nonsmokers (FIG. 1). Secreted EMAPII (mature form) expression in the BAL acellular fluid of smokers wascompared to non-smokers, as measured by Western blotting with a specificEMAP II antibody. Levels measured by densitometry of EMAP II expressionin individual BAL samples. (Mean±SEM,*p=<0.01).

Example 16 Extraction of Total RNA from Hybridomas

First-round of RT-PCT. QIAGEN® OneStep RT-PCR Kit (Cat No. 210210) wasused. RNA was isolation using a Qiagen kit according to standard methodsin conformity with the manufacture's and the instructions. Briefly,RT-PCR was performed with primer sets specific for the heavy and lightchains. For each RNA sample, 12 individual heavy chain and 11 lightchain RT-PCR reactins were set up using degenerate forward primermixtures covering the leader sequences of variable regions. Reverseprimers are located in the constant regions of heavy and light chains.No restriction sites were engineered into the primers.

Second-round semi-nested PCR. The RT-PCR products from the first-roundreactions were further amplified in the second-round PCR. 12 individualheavy chain and 11 light chain RT-PCR reactions were set up usingsem-nested primer sets specific for antibody variable regions.

Referring now to FIG. 13. After PCR was finished, a PCR reaction was runand samples from the PCR reaction were run onto an agarose gel tovisualize the DNA fragments amplified. The correct antibody variableregion DNA fragments should have a size between 400-500 base pair.

Referring now to FIGS. 14 and 15. After sequencing more than 15 DNAfragments amplified by nested RT-PCR, several antibody heavy and lightchains were cloned. The protein sequence and alignment and CDR analysisidentified one heavy chain and one light chain

Example 17 EMAP II Epitope Peptide Sequence Identification

Referring now to FIGS. 16 and 17. Based on the protocol of Parker andTomer, tryptic digestion-derived peptides of protein bound to anothercompound (such as an antibody) maybe protected from digestion at thebinding site. (Parker, C. et al., MALDI/MS-based epitope mapping ofantigens bound to immobilized antibodies, Molecular Biotechnology,Volume 20, Number 1 (2002), 49-62). Accordingly, the portion of aprotein bound to a sepharose-immobilized M7/1 antibody would likely beprotected from proteolysis.

A binding competition was performed using human recombinant pro-EMAP IIand the M7/1 antibody. Referring now to FIG. 17. Recombinant pro-EMAP IIwas submitted to Western blotting using control IgG and EMAP IIneutralizing M7/1 antibody in the presence/absence of a 300 fold molarexcess of peptide hexadecamers. Only Peptide 2 (QQSIAGSADSKPIDVSR) butnot Peptide 1 (KHPDADSLYVEEVDVGE) or Peptide 3 (as a control) was ableto compete with M7/1. Arrows indicate the position of molecular weightstandards (in rel kDa).

Peptides in the pull-down fraction were identified by liquidchromatography tandem mass spectrometry (LC-MS/MS). By analyzing thesequences bound to protein G sepharose immobilized M7/1 antibody,protected peptides ranging over the sequenceQQSIAGSADSKPIDVSRLDLRIGCIITARKHPDADSLYVEEVDVGEIAPRTVVS GLVNHVPLEQMQNRM(SEQ. ID NO. 11) were identified. From this peptide sequences 2hexadecamer peptides randomly chosen for competition in M7/1 Westernblotting: Peptide 1: KHPDADSLYVEEVDVGE (SEQ. ID NO. 13) and Peptide 2:QQSIAGSADSKPIDVSR (SEQ. ID NO. 12). A Western blotting competition assaywas used in order to determine which polypeptide is the best epitope. Inthis assay, M7/1 antibody binding to recombinant pro-EMAP II wasperformed in the presence of a 300-fold excess of hexadecamer Peptides 1or 2 or a control Peptide 3: VLKRLEQKGAEADQIIE (SEQ. ID NO. 14). Peptide2 competed strongly for the M7/1 antibody binding as indicated by theabsence of a Western blot band for M7/1 staining, whereas the otheridentified Peptide 1 and the control Peptide 3 had no effect.

It should be understood, of course, that the foregoing relates toexemplary embodiments of the invention and that modifications may bemade without departing from the spirit and scope of the invention as setforth in the following claims.

While the novel technology has been illustrated and described in detailin the figures and foregoing description, the same is to be consideredas illustrative and not restrictive in character, it being understoodthat only the preferred embodiments have been shown and described andthat all changes and modifications that come within the spirit of thenovel technology are desired to be protected. As well, while the noveltechnology was illustrated using specific examples, theoreticalarguments, accounts, and illustrations, these illustrations and theaccompanying discussion should by no means be interpreted as limitingthe technology. All patents, patent applications, and references totexts, scientific treatises, publications, and the like referenced inthis application are incorporated herein by reference in their entirety.

We claim:
 1. An antibody, comprising: a heavy chain variable region,wherein said heavy chain variable region includes at least a portion ofa first polypeptide according to SEQ. ID. NO. 2; and a light chainvariable region, wherein said light chain variable region includes atleast a portion of a second polypeptide according to SEQ. ID. NO. 3,wherein said antibody is humanized and the humanized antibody binds tohuman EMAPII.
 2. The antibody according to claim 1, wherein said firstpolypeptide has at least 99 percent homology to SEQ. ID. NO. 2, and saidsecond polypeptide has at least 99 percent homology to SEQ. ID. NO. 3.3. The antibody according to claim 1, wherein said first polypeptide hasat least 95 percent identity to SEQ. ID. NO. 2 and said secondpolypeptide has at least 95 percent identity to SEQ. ID. NO.
 3. 4. Theantibody according to claim 1, wherein said first polypeptide has atleast 99 percent identity to SEQ. ID. NO. 2 and said second polypeptidehas at least 99 percent identity to SEQ. ID. NO.
 3. 5. The antibodyaccording to claim 1, wherein said first polypeptide is SEQ. ID. NO. 2and said second polypeptide is SEQ. ID. NO.
 3. 6. An antibody,comprising: a heavy chain, wherein said heavy chain includes the heavychain hypervariable regions CDR1, CDR2 and CDR3, wherein CDR1 includesat least a portion of the polypeptide according to SEQ. ID. NO. 5, CDR2includes at least a portion of the polypeptide according to SEQ. ID. NO.6, and CDR3 includes at least a portion of the polypeptide according toSEQ. ID. NO. 7; and a light chain, wherein said light chain includes thelight chain hypervariable regions CDR1_(L), CDR2_(L), and CDR3_(L),wherein CDR1_(L) includes at least a portion of the polypeptideaccording to SEQ. ID. NO. 8, CDR2_(L) includes at least a portion of thepolypeptide according to SEQ. ID. NO. 9 and CDR3_(L) includes at least aportion of the polypeptide according to SEQ. ID. NO. 10, wherein theheavy chain and the light chain form a portion of a humanized antibody,that binds to human EMAPII.
 7. The humanized antibody according to claim6, wherein: CDR1 is SEQ. ID. NO. 5, CDR2 is SEQ. ID. NO. 6, and CDR3 isSEQ. ID. NO. 7; CDR1_(L) his SEQ. ID. NO. 8, CDR2_(L) is SEQ. ID. NO. 9,and CDR3_(L) is SEQ. ID. NO.
 10. 8. An epitope, comprising: an epitopeof human EMAP II, wherein said epitope includes at least a portion of anisolated polypeptide according to SEQ. ID. NO.
 12. 9. The epitope,according to claim 8, wherein said isolated polypeptide has at least 95percent homology to SEQ. ID. NO.
 12. 10. The epitope, according to claim8, wherein said isolated polypeptide has at least 99 percent homology toSEQ. ID. NO.
 12. 11. The epitope, according to claim 8, wherein saidisolated polypeptide has at least 95 percent identity to SEQ. ID. NO.12.
 12. The epitope, according to claim 8, wherein said isolatedpolypeptide has at least 99 percent identity to SEQ. ID. NO.
 12. 13. Theepitope, according to claim 8, wherein said isolated polypeptide is SEQ.ID. NO.
 12. 14. The epitope, according to claim 8, wherein said isolatedpolypeptide has at least 95 percent identity to SEQ. ID. NO.
 11. 15. Theepitope, according to claim 8, wherein said isolated polypeptide has atleast 99 percent identity to SEQ. ID. NO.
 11. 16. The epitope, accordingto claim 8, wherein said isolated polypeptide is SEQ. ID. NO.
 11. 17. Amethod of making an antibody, comprising the steps of: producing asynthetic polypeptide wherein at least one portion of the syntheticpolypeptide includes at least a portion of the polypeptide according toSEQ. ID. NO.
 12. 18. The method according to claim 17, wherein said atleast one portion of the synthetic polypeptide has at least 95 percenthomology to SEQ. ID. NO.
 12. 19. The method according to claim 17,wherein said at least one portion of the synthetic polypeptide has atleast 99 percent homology to SEQ. ID. NO.
 12. 20. The method accordingto claim 17, wherein said at least one portion of the syntheticpolypeptide has at least 95 percent identity to SEQ. ID. NO.
 12. 21-29.(canceled)